Active NPI
Emily Bousquin Sulloway, MS, RDN, LDN
- Registered Dietitian
- Cambridge, MA
National Provider Identifier
1174169957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4916-NU-NU
- Practice address
- 3 Bow St
Cambridge, MA 02138-5109 - Phone
- (617) 547-2255
- Fax
- (617) 547-0003
- NPI assigned
- Nov 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 4916-NU-NU | MA | Primary |
Addresses
Primary practice location
3 Bow St
Cambridge, MA 02138-5109
Mailing address
3 Bow St
Cambridge, MA 02138-5109
Phone (617) 547-2255
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | esulloway@cedcmail.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4916-NU-NU | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574812800000",
"number": "1174169957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 BOW ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021385109",
"telephone_number": "617-547-2255",
"fax_number": "617-547-0003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 BOW ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021385109",
"telephone_number": "617-547-2255",
"fax_number": "617-547-0003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLOWAY",
"first_name": "EMILY",
"middle_name": "BOUSQUIN",
"credential": "MS, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-27",
"last_updated": "2019-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4916-NU-NU",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "esulloway@cedcmail.com",
"affiliation": "N",
"endpointDescription": "work email",
"address_1": "3 Bow St",
"city": "Cambridge",
"state": "MA",
"country_code": "US",
"postal_code": "021385109",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.